Welcome to Francis Academic Press

Academic Journal of Medicine & Health Sciences, 2025, 6(5); doi: 10.25236/AJMHS.2025.060507.

Exploration on the Relationship between Intestinal Microbiota and Diabetic Kidney Disease Based on the Theory of the Correlation between the Spleen and Kidney

Author(s)

Ren Yuyu1, Lei Genping2

Corresponding Author:
Lei Genping
Affiliation(s)

1Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China

2Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000, Shaanxi, China

Abstract

Diabetic Kidney Disease (DKD) is a major microvascular complication of diabetes. Its pathogenesis is complex and involves multiple factors such as metabolic disorders, inflammatory responses, and intestinal microbiota dysbiosis. This article takes the traditional Chinese medicine (TCM) theory of "the correlation between the spleen and kidney" as the core, systematically explores the role of the intestinal microbiota in the occurrence and development of DKD, and proposes a pathological model of the "spleen-kidney-intestinal microbiota axis". By integrating the physiological functions of TCM, namely "the spleen governing transportation and transformation, and the kidney governing water metabolism", with the metabolic regulation and immune-inflammatory mechanisms mediated by the intestinal microbiota in Western medicine, this article reveals the molecular pathways through which deficiency of both the spleen and kidney leads to intestinal microbiota dysbiosis, intestinal barrier damage, and the accumulation of uremic toxins. It provides new ideas for the integrated treatment of DKD combining traditional Chinese and Western medicine.

Keywords

Theory of the Correlation between the Spleen and Kidney; Intestinal Microbiota; Diabetic Kidney Disease; Intestine-Kidney Axis; Integration of Traditional Chinese and Western Medicine

Cite This Paper

Ren Yuyu, Lei Genping. Exploration on the Relationship between Intestinal Microbiota and Diabetic Kidney Disease Based on the Theory of the Correlation between the Spleen and Kidney. Academic Journal of Medicine & Health Sciences (2025), Vol. 6, Issue 5: 40-46. https://doi.org/10.25236/AJMHS.2025.060507.

References

[1] Eckardt Kai-Uwe, Kasiske Bertram L, . Kidney disease: improving global outcomes [J]. Nature reviews. Nephrology, 2009, 5(11):650-657.

[2] Mao Zihui, et al. Gut microbiota and its metabolites – molecular mechanisms and management strategies in diabetic kidney disease [J]. Frontiers in Immunology, 2023, 14:1124704. 

[3] Levy Maayan, Kolodziejczyk Aleksandra A, Thaiss Christoph A, et al. Dysbiosis and the immune system [J]. Nature reviews. Immunology, 2017, 17(4):219-232. 

[4] Eunyoung Chun, Sydney Lavoie, Diogo Fonseca-Pereira, et al. Metabolite-Sensing Receptor Ffar2 Regulates Colonic Group 3 Innate Lymphoid Cells and Gut Immunity [J]. Immunity, 2019, 51(5):871-884. 

[5] Yuan Tingting, Cui Weifeng. Discussion on the Differentiation and Treatment of Diabetes Nephropathy in Traditional Chinese Medicine based on the Theory of "Spleen Kidney Correlation" [J/OL]. Journal of Traditional Chinese Medicine, 1-4 [2025-04-30] http:// kns.cnki.net/ kcms/ detail/ 41.1411.R.20241127.1632.050.html. 

[6] Wei Weichao, Wu Wei, Wang Chuangchang. Application of Deng Tietao's Theory of the Correlation of Five Zang Organs in the Treatment of Chronic Obstructive Pulmonary Disease[J]. Journal of Traditional Chinese Medicine, 2017, (23): 2068-2070. 

[7] Jiang Hui, Mi Jie, Wang Dongyan, et al. Treating Kidney Diseases from Spleen [J]. Shandong Journal of Traditional Chinese Medicine, 2022, (03): 259-263. 

[8] Lozupone Catherine A, Stombaugh Jesse I, Gordon Jeffrey I, et al. Diversity, stability and resilience of the human gut microbiota [J]. Nature, 2012, 489(7415):220-230. 

[9] Shanahan Fergus, Ghosh Tarini S., O’Toole Paul W., et al. The Healthy Microbiome (What Is the Definition of a Healthy Gut Microbiome?) [J]. Gastroenterology, 2020, 160(2): 483-494. 

[10] De Vos Willem M, de Vos Elisabeth A J, . Role of the intestinal microbiome in health and disease: from correlation to causation [J]. Nutrition reviews, 2012, 701(81):S45-56. 

[11] Relman David A, . The human microbiome: ecosystem resilience and health [J]. Nutrition reviews, 2012, 701(81):S2-9. 

[12] Burger-van Paassen Nanda, Vincent Audrey, Puiman Patrycja J, et al. The regulation of intestinal mucin MUC2 expression by short-chain fatty acids: implications for epithelial protection [J]. The Biochemical journal, 2009, 420(2):211-219.  

[13] Sekirov Inna, Russell Shannon L, Antunes L Caetano M, et al. Gut microbiota in health and disease.[J]. Physiological reviews, 2010, 90(3):859-904. 

[14] Montiel-Castro Augusto J, González-Cervantes Rina M, Bravo-Ruiseco Gabriela, et al. The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality.[J]. Frontiers in integrative neuroscience, 2013, 7:70. 

[15] Secundino Cigarran Guldris, Emilio González Parra, Aleix Cases Amenós, et al. Gut microbiota in chronic kidney disease[J]. Nefrología (English Edition), 2017, 37(1):9-19. 

[16] Xu Huihui, Zhao Hongyan, Cao Jinfeng, et al. Discussion of The Spleen Kidney Related Mechanism in The Occurrence of Osteoporosis Based on Gut Microbiota [J]. Chinese Journal of Basic Chinese Medicine, 2021, 27(04): 550-553. 

[17] Zheng Jie, Li Xiaosheng, Peng Feng, et al. Effect of Shenshuaining Capsules on Indoxyl Sulfate in 54 Patients with Carotid Artery Atherosclerosis at Stages 3-5 of Chronic Kidney Disease[J]. Chinese Journal of Integrated Traditional and Western Nephrology, 2020, (12): 1077-1078. 

[18] Lei Tianxiang, Lin Shaoqin, Fu Jurong, et al. Based on the Theory of Gut-kidney Axis to Explore the Effect of Auricular Acupoint Pressing Beans on Intestinal-derived Uremic Toxins in Uremic Dialysis Patients and the Related Mechanism[J]. Chinese Journal of Integrated Traditional and Western Nephrology, 2024, 25(04): 1-5. 

[19] Ren Jing, Li Yusi, Li Huimin, et al. Treatment of Diabetic Constipation from Spleen Deficiency Based on Intestinal Flora [J]. World Journal of Integrated Traditional and Western Medicine, 2024, 19(02): 399-403+414. 

[20] Yang Chunjia, Su Dewang, Wang Yuesheng, et al. The adjustment of double flower on obstructive jaundice rats' intestinal microflora imbalance [J]. China Modern Doctor, 2012, (24): 3-4+9. 

[21] Kelly C R, Clemente J C, Knight R, et al. Microbiota transplantation in clinical practice: challenges and future directions [J]. Nature medicine, 2016, 22 (3): 235-242. 

[22] Franzosa E A, Xavier R J. Personalized microbiome medicine [J]. Cell, 2019, 179 (4): 846-860.